Liverpool HIV Interactions

Cookies help us deliver our services. By using our services, you agree to our use of cookies. Learn more

Potential Weak Interaction

Lopinavir/ritonavir (LPV/r)

Dolutegravir/Lamivudine (DTG/3TC)

Quality of Evidence: Very Low

Summary:

Dovato (dolutegravir/lamivudine) is indicated for use as a complete regimen for the treatment of HIV 1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with lopinavir/ritonavir would be possible from a pharmacokinetic standpoint. The European product label for Dovato advises that no dose adjustment is necessary with lopinavir/ritonavir. Coadministration of lopinavir and dolutegravir decreased dolutegravir AUC and C24 by 4% and 6% and had no effect on Cmax; there was no effect on lopinavir or ritonavir. No change in the pharmacokinetics of lopinavir was observed with stavudine and lamivudine in clinical studies.

Description:

Coadministration of dolutegravir and lopinavir/ritonavir decreased dolutegravir AUC and Cmin by 4% and 6%, due to induction of UGT1A1 and CYP3A enzymes, but there was no change in Cmax. There was no change in lopinavir or ritonavir pharmacokinetics. No dose adjustment is necessary.

Dovato Summary of Product Characteristics, ViiV Healthcare, July 2019.

Dovato is a complete regimen for the treatment of HIV-1 infection; therefore, coadministration with other antiretroviral drugs for the treatment of HIV-1 infection is not recommended.

Dovato US Prescribing Information, ViiV Healthcare, April 2019.

Coadministration of dolutegravir (30 mg once daily) and lopinavir/ritonavir (400/100 mg twice daily) was studied in 15 HIV-negative subjects. Coadministration had no significant effects on dolutegravir pharmacokinetics (no change in Cmax, 3% decrease in AUC, 2% increase in Ctrough). The authors recommend no dose adjustment when dolutegravir is coadministered with lopinavir/ritonavir. Note, this study was performed with a dose of dolutegravir lower than the licensed one.

The effect of lopinavir/ritonavir and darunavir/ritonavir on the HIV integrase inhibitor S/GSK1349572 in healthy participants. Song I, Min SS, Borland J, et al. J Clin Pharmacol, 2011, 51: 237-242.

Plasma concentrations of lamivudine (300 mg once daily) with lopinavir/ritonavir (400/100 mg twice daily, n=7) or nevirapine (400 mg once daily, n=8) were determined in HIV positive patients. Lamivudine AUC, Cmax and Ctrough were 11%, 21% and 45% higher, respectively in the presence of lopinavir/ritonavir when compared to nevirapine. The changes in lamivudine disposition were not significant.

Pilot pharmacokinetic study of Human Immunodeficiency Virus-infected patients receiving tenofovir disoproxil fumarate (TDF): Investigation of systemic and intracellular interactions between TDF and abacavir, lamivudine, or lopinavir-ritonavir. Pruvost A, Negredo E, Théodoro F, et al. Antimicrob Agents Chemother, 2009, 53(5): 1937-1943.

View all available interactions with Lopinavir/ritonavir (LPV/r) by clicking here.